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  1. AU="García-Carrera, Inés"
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  3. AU="Ferragalli, Beatrice"
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  5. AU="Acin, Yolène"
  6. AU="Zarrintan, Armin"
  7. AU="Anne Schedel"
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  10. AU="Liu, Changxue"
  11. AU="Spruit, Martijn A"
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  1. Artikel ; Online: Congestive Hepatopathy.

    Fortea, José Ignacio / Puente, Ángela / Cuadrado, Antonio / Huelin, Patricia / Pellón, Raúl / González Sánchez, Francisco José / Mayorga, Marta / Cagigal, María Luisa / García Carrera, Inés / Cobreros, Marina / Crespo, Javier / Fábrega, Emilio

    International journal of molecular sciences

    2020  Band 21, Heft 24

    Abstract: Liver disease resulting from heart failure (HF) has generally been referred as "cardiac hepatopathy". One of its main forms is congestive hepatopathy (CH), which results from passive venous congestion in the setting of chronic right-sided HF. The current ...

    Abstract Liver disease resulting from heart failure (HF) has generally been referred as "cardiac hepatopathy". One of its main forms is congestive hepatopathy (CH), which results from passive venous congestion in the setting of chronic right-sided HF. The current spectrum of CH differs from earlier reports with HF, due to ischemic cardiomyopathy and congenital heart disease having surpassed rheumatic valvular disease. The chronic passive congestion leads to sinusoidal hypertension, centrilobular fibrosis, and ultimately, cirrhosis ("cardiac cirrhosis") and hepatocellular carcinoma after several decades of ongoing injury. Contrary to primary liver diseases, in CH, inflammation seems to play no role in the progression of liver fibrosis, bridging fibrosis occurs between central veins to produce a "reversed lobulation" pattern and the performance of non-invasive diagnostic tests of liver fibrosis is poor. Although the clinical picture and prognosis is usually dominated by the underlying heart condition, the improved long-term survival of cardiac patients due to advances in medical and surgical treatments are responsible for the increased number of liver complications in this setting. Eventually, liver disease could become as clinically relevant as cardiac disease and further complicate its management.
    Mesh-Begriff(e) Heart Failure/complications ; Humans ; Liver/blood supply ; Liver/metabolism ; Liver/pathology ; Liver Circulation ; Liver Diseases/diagnosis ; Liver Diseases/epidemiology ; Liver Diseases/etiology ; Liver Diseases/therapy
    Sprache Englisch
    Erscheinungsdatum 2020-12-10
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms21249420
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel: Is Routine Prophylaxis Against

    Fortea, José Ignacio / Cuadrado, Antonio / Puente, Ángela / Álvarez Fernández, Paloma / Huelin, Patricia / Álvarez Tato, Carmen / García Carrera, Inés / Cobreros, Marina / Cagigal Cobo, María Luisa / Calvo Montes, Jorge / Ruiz de Alegría Puig, Carlos / Rodríguez SanJuán, Juan Carlos / Castillo Suescun, Federico José / Fernández Santiago, Roberto / Echeverri Cifuentes, Juan Andrés / Casafont, Fernando / Crespo, Javier / Fábrega, Emilio

    Journal of clinical medicine

    2020  Band 9, Heft 11

    Abstract: In liver transplant (LT) recipients, ...

    Abstract In liver transplant (LT) recipients,
    Sprache Englisch
    Erscheinungsdatum 2020-11-06
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm9113573
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: MELD 3.0 adequately predicts mortality and renal replacement therapy requirements in patients with alcohol-associated hepatitis.

    Díaz, Luis Antonio / Fuentes-López, Eduardo / Ayares, Gustavo / Idalsoaga, Francisco / Arnold, Jorge / Valverde, María Ayala / Perez, Diego / Gómez, Jaime / Escarate, Rodrigo / Villalón, Alejandro / Ramírez, Carolina A / Hernandez-Tejero, Maria / Zhang, Wei / Qian, Steve / Simonetto, Douglas A / Ahn, Joseph C / Buryska, Seth / Dunn, Winston / Mehta, Heer /
    Agrawal, Rohit / Cabezas, Joaquín / García-Carrera, Inés / Cuyàs, Berta / Poca, Maria / Soriano, German / Sarin, Shiv K / Maiwall, Rakhi / Jalal, Prasun K / Abdulsada, Saba / Higuera-de-la-Tijera, Fátima / Kulkarni, Anand V / Rao, P Nagaraja / Salazar, Patricia Guerra / Skladaný, Lubomir / Bystrianska, Natália / Clemente-Sanchez, Ana / Villaseca-Gómez, Clara / Haider, Tehseen / Chacko, Kristina R / Romero, Gustavo A / Pollarsky, Florencia D / Restrepo, Juan Carlos / Castro-Sanchez, Susana / Toro, Luis G / Yaquich, Pamela / Mendizabal, Manuel / Garrido, Maria Laura / Marciano, Sebastián / Dirchwolf, Melisa / Vargas, Victor / Jiménez, César / Louvet, Alexandre / García-Tsao, Guadalupe / Roblero, Juan Pablo / Abraldes, Juan G / Shah, Vijay H / Kamath, Patrick S / Arrese, Marco / Singal, Ashwani K / Bataller, Ramon / Arab, Juan Pablo

    JHEP reports : innovation in hepatology

    2023  Band 5, Heft 8, Seite(n) 100727

    Abstract: Background & aims: Model for End-Stage Liver Disease (MELD) score better predicts mortality in alcohol-associated hepatitis (AH) but could underestimate severity in women and malnourished patients. Using a global cohort, we assessed the ability of the ... ...

    Abstract Background & aims: Model for End-Stage Liver Disease (MELD) score better predicts mortality in alcohol-associated hepatitis (AH) but could underestimate severity in women and malnourished patients. Using a global cohort, we assessed the ability of the MELD 3.0 score to predict short-term mortality in AH.
    Methods: This was a retrospective cohort study of patients admitted to hospital with AH from 2009 to 2019. The main outcome was all-cause 30-day mortality. We compared the AUC using DeLong's method and also performed a time-dependent AUC with competing risks analysis.
    Results: A total of 2,124 patients were included from 28 centres from 10 countries on three continents (median age 47.2 ± 11.2 years, 29.9% women, 71.3% with underlying cirrhosis). The median MELD 3.0 score at admission was 25 (20-33), with an estimated survival of 73.7% at 30 days. The MELD 3.0 score had a better performance in predicting 30-day mortality (AUC:0.761, 95%CI:0.732-0.791) compared with MELD sodium (MELD-Na; AUC: 0.744, 95% CI: 0.713-0.775;
    Conclusions: MELD 3.0 demonstrated better performance compared with MELD-Na and mDF in predicting 30-day and 90-day mortality, and was the best predictor of renal replacement therapy requirements during admission for AH. However, further prospective studies are needed to validate its extensive use in AH.
    Impact and implications: Severe AH has high short-term mortality. The establishment of treatments and liver transplantation depends on mortality prediction. We evaluated the performance of the new MELD 3.0 score to predict short-term mortality in AH in a large global cohort. MELD 3.0 performed better in predicting 30- and 90-day mortality compared with MELD-Na and mDF, but was similar to MELD and ABIC scores. MELD 3.0 was the best predictor of renal replacement therapy requirements. Thus, further prospective studies are needed to support the wide use of MELD 3.0 in AH.
    Sprache Englisch
    Erscheinungsdatum 2023-03-15
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ISSN 2589-5559
    ISSN (online) 2589-5559
    DOI 10.1016/j.jhepr.2023.100727
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Identification of optimal therapeutic window for steroid use in severe alcohol-associated hepatitis: A worldwide study.

    Arab, Juan Pablo / Díaz, Luis Antonio / Baeza, Natalia / Idalsoaga, Francisco / Fuentes-López, Eduardo / Arnold, Jorge / Ramírez, Carolina A / Morales-Arraez, Dalia / Ventura-Cots, Meritxell / Alvarado-Tapias, Edilmar / Zhang, Wei / Clark, Virginia / Simonetto, Douglas / Ahn, Joseph C / Buryska, Seth / Mehta, Tej I / Stefanescu, Horia / Horhat, Adelina / Bumbu, Andreea /
    Dunn, Winston / Attar, Bashar / Agrawal, Rohit / Haque, Zohaib Syed / Majeed, Muhammad / Cabezas, Joaquín / García-Carrera, Inés / Parker, Richard / Cuyàs, Berta / Poca, Maria / Soriano, German / Sarin, Shiv K / Maiwall, Rakhi / Jalal, Prasun K / Abdulsada, Saba / Higuera-de la Tijera, María Fátima / Kulkarni, Anand V / Rao, P Nagaraja / Guerra Salazar, Patricia / Skladaný, Lubomir / Bystrianska, Natália / Prado, Veronica / Clemente-Sanchez, Ana / Rincón, Diego / Haider, Tehseen / Chacko, Kristina R / Cairo, Fernando / de Sousa Coelho, Marcela / Romero, Gustavo A / Pollarsky, Florencia D / Restrepo, Juan Carlos / Castro-Sanchez, Susana / Toro, Luis G / Yaquich, Pamela / Mendizabal, Manuel / Garrido, Maria Laura / Narvaez, Adrián / Bessone, Fernando / Marcelo, Julio Santiago / Piombino, Diego / Dirchwolf, Melisa / Arancibia, Juan Pablo / Altamirano, José / Kim, Won / Araujo, Roberta C / Duarte-Rojo, Andrés / Vargas, Victor / Rautou, Pierre-Emmanuel / Issoufaly, Tazime / Zamarripa, Felipe / Torre, Aldo / Lucey, Michael R / Mathurin, Philippe / Louvet, Alexandre / García-Tsao, Guadalupe / González, José Alberto / Verna, Elizabeth / Brown, Robert S / Roblero, Juan Pablo / Abraldes, Juan G / Arrese, Marco / Shah, Vijay H / Kamath, Patrick S / Singal, Ashwani K / Bataller, Ramon

    Journal of hepatology

    2021  Band 75, Heft 5, Seite(n) 1026–1033

    Abstract: Background & aims: Corticosteroids are the only effective therapy for severe alcohol-associated hepatitis (AH), defined by a model for end-stage liver disease (MELD) score >20. However, there are patients who may be too sick to benefit from therapy. ... ...

    Abstract Background & aims: Corticosteroids are the only effective therapy for severe alcohol-associated hepatitis (AH), defined by a model for end-stage liver disease (MELD) score >20. However, there are patients who may be too sick to benefit from therapy. Herein, we aimed to identify the range of MELD scores within which steroids are effective for AH.
    Methods: We performed a retrospective, international multicenter cohort study across 4 continents, including 3,380 adults with a clinical and/or histological diagnosis of AH. The main outcome was mortality at 30 days. We used a discrete-time survival analysis model, and MELD cut-offs were established using the transform-the-endpoints method.
    Results: In our cohort, median age was 49 (40-56) years, 76.5% were male, and 79% had underlying cirrhosis. Median MELD at admission was 24 (19-29). Survival was 88% (87-89) at 30 days, 77% (76-78) at 90 days, and 72% (72-74) at 180 days. A total of 1,225 patients received corticosteroids. In an adjusted-survival-model, corticosteroid use decreased 30-day mortality by 41% (hazard ratio [HR] 0.59; 0.47-0.74; p <0.001). Steroids only improved survival in patients with MELD scores between 21 (HR 0.61; 0.39-0.95; p = 0.027) and 51 (HR 0.72; 0.52-0.99; p = 0.041). The maximum effect of corticosteroid treatment (21-30% survival benefit) was observed with MELD scores between 25 (HR 0.58; 0.42-0.77; p <0.001) and 39 (HR 0.57; 0.41-0.79; p <0.001). No corticosteroid benefit was seen in patients with MELD >51. The type of corticosteroids used (prednisone, prednisolone, or methylprednisolone) was not associated with survival benefit (p = 0.247).
    Conclusion: Corticosteroids improve 30-day survival only among patients with severe AH, especially with MELD scores between 25 and 39.
    Lay summary: Alcohol-associated hepatitis is a condition where the liver is severely inflamed as a result of excess alcohol use. It is associated with high mortality and it is not clear whether the most commonly used treatments (corticosteroids) are effective, particularly in patients with very severe liver disease. In this worldwide study, the use of corticosteroids was associated with increased 30-day, but not 90- or 180-day, survival. The maximal benefit was observed in patients with an MELD score (a marker of severity of liver disease; higher scores signify worse disease) between 25-39. However, this benefit was lost in patients with the most severe liver disease (MELD score higher than 51).
    Mesh-Begriff(e) Adult ; Alcohol Drinking/adverse effects ; Alcohol Drinking/drug therapy ; Alcohol Drinking/physiopathology ; Cohort Studies ; Female ; Hepatitis/drug therapy ; Hepatitis/etiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Steroids/administration & dosage ; Steroids/therapeutic use ; Time Factors
    Chemische Substanzen Steroids
    Sprache Englisch
    Erscheinungsdatum 2021-06-21
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2021.06.019
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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